Risk-adjusted capitation: Recent experiences in the Netherlands

W. P.M.M. Van De Ven*, R. C.J.A. Van Vliet, E. M. Van Barneveld, L. M. Lamers

*Corresponding author for this work

Research output: Contribution to journalReview articleProfessionalpeer-review

36 Citations (Scopus)


The market-oriented health care reforms taking place in the Netherlands show a clear resemblance to the proposals for managed competition in U.S. health care. In both countries good risk adjustment mechanisms that prevent cream skimming - that is, that prevent plans from selecting the best health risks - are critical to the success of the reforms. In this paper we present an overview of the Dutch reforms and of our research concerning risk-adjusted capitation payments. Although we are optimistic about the technical possibilities for solving the problem of cream skimming, the implementation of good risk-adjusted capitation is a long-term challenge.

Original languageEnglish
Pages (from-to)120-136
Number of pages17
JournalHealth Affairs
Issue number5
Publication statusPublished - 1994


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